| NPI | 1417736893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15519) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IN 22008148A) |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2024-07-24 |